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Volmrich AM, Cuénant LM, Forghani I, Hsieh SL, Shapiro LT. ABCD1 Gene Mutations: Mechanisms and Management of Adrenomyeloneuropathy. Appl Clin Genet 2022; 15:111-123. [PMID: 35983253 PMCID: PMC9381027 DOI: 10.2147/tacg.s359479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Accepted: 08/06/2022] [Indexed: 01/05/2023] Open
Abstract
Pathogenic variants in the ABCD1 gene on the X chromosome may result in widely heterogenous phenotypes, including adrenomyeloneuropathy (AMN). Affected males typically present in their third or fourth decade of life with progressive lower limb weakness and spasticity, and may develop signs and symptoms of adrenal insufficiency and/or cerebral demyelination. Heterozygous females may be asymptomatic, but may develop a later-onset and more slowly progressive spastic paraparesis. In this review, we describe the clinical presentation of AMN, as well as its diagnosis and management. The role of rehabilitative therapies and options for management of spasticity are highlighted.
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Affiliation(s)
- Alyssa M Volmrich
- Department of Physical Medicine & Rehabilitation, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Lauren M Cuénant
- Department of Physical Medicine & Rehabilitation, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Irman Forghani
- Department of Human Genetics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Sharon L Hsieh
- MD/MPH Program, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Lauren T Shapiro
- Department of Physical Medicine & Rehabilitation, University of Miami Miller School of Medicine, Miami, FL, USA
- Correspondence: Lauren T Shapiro, Department of Physical Medicine & Rehabilitation; University of Miami Miller School of Medicine, P.O. Box 016960 (C-206), Miami, FL, 33101, USA, Tel +1 305 243-6605, Fax +1 305 243-4650, Email
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Gong Y, Laheji F, Berenson A, Qian A, Park SO, Kok R, Selig M, Hahn R, Sadjadi R, Kemp S, Eichler F. Peroxisome Metabolism Contributes to PIEZO2-Mediated Mechanical Allodynia. Cells 2022; 11:1842. [PMID: 35681537 PMCID: PMC9180358 DOI: 10.3390/cells11111842] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 05/21/2022] [Accepted: 06/01/2022] [Indexed: 11/17/2022] Open
Abstract
Mutations in the peroxisomal half-transporter ABCD1 cause X-linked adrenoleukodystrophy, resulting in elevated very long-chain fatty acids (VLCFA), progressive neurodegeneration and an associated pain syndrome that is poorly understood. In the nervous system of mice, we found ABCD1 expression to be highest in dorsal root ganglia (DRG), with satellite glial cells (SGCs) displaying higher expression than neurons. We subsequently examined sensory behavior and DRG pathophysiology in mice deficient in ABCD1 compared to wild-type mice. Beginning at 8 months of age, Abcd1-/y mice developed persistent mechanical allodynia. DRG had a greater number of IB4-positive nociceptive neurons expressing PIEZO2, the mechanosensitive ion channel. Blocking PIEZO2 partially rescued the mechanical allodynia. Beyond affecting neurons, ABCD1 deficiency impacted SGCs, as demonstrated by high levels of VLCFA, increased glial fibrillary acidic protein (GFAP), as well as genes disrupting neuron-SGC connectivity. These findings suggest that lack of the peroxisomal half-transporter ABCD1 leads to PIEZO2-mediated mechanical allodynia as well as SGC dysfunction. Given the known supportive role of SGCs to neurons, this elucidates a novel mechanism underlying pain in X-linked adrenoleukodystrophy.
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Affiliation(s)
- Yi Gong
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA; (Y.G.); (F.L.); (A.B.); (A.Q.); (S.-O.P.); (M.S.); (R.H.); (R.S.)
| | - Fiza Laheji
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA; (Y.G.); (F.L.); (A.B.); (A.Q.); (S.-O.P.); (M.S.); (R.H.); (R.S.)
| | - Anna Berenson
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA; (Y.G.); (F.L.); (A.B.); (A.Q.); (S.-O.P.); (M.S.); (R.H.); (R.S.)
| | - April Qian
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA; (Y.G.); (F.L.); (A.B.); (A.Q.); (S.-O.P.); (M.S.); (R.H.); (R.S.)
| | - Sang-O Park
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA; (Y.G.); (F.L.); (A.B.); (A.Q.); (S.-O.P.); (M.S.); (R.H.); (R.S.)
| | - Rene Kok
- Laboratory Genetic Metabolic Diseases, Department of Clinical Chemistry, Amsterdam University Medical Center, Amsterdam Gastroenterology Endocrinology Metabolism, University of Amsterdam, 1105 Amsterdam, The Netherlands; (R.K.); (S.K.)
| | - Martin Selig
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA; (Y.G.); (F.L.); (A.B.); (A.Q.); (S.-O.P.); (M.S.); (R.H.); (R.S.)
| | - Ryan Hahn
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA; (Y.G.); (F.L.); (A.B.); (A.Q.); (S.-O.P.); (M.S.); (R.H.); (R.S.)
| | - Reza Sadjadi
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA; (Y.G.); (F.L.); (A.B.); (A.Q.); (S.-O.P.); (M.S.); (R.H.); (R.S.)
| | - Stephan Kemp
- Laboratory Genetic Metabolic Diseases, Department of Clinical Chemistry, Amsterdam University Medical Center, Amsterdam Gastroenterology Endocrinology Metabolism, University of Amsterdam, 1105 Amsterdam, The Netherlands; (R.K.); (S.K.)
- Department of Pediatric Neurology, Emma Children’s Hospital, Amsterdam University Medical Center, Amsterdam Neuroscience, University of Amsterdam, 1105 Amsterdam, The Netherlands
| | - Florian Eichler
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA; (Y.G.); (F.L.); (A.B.); (A.Q.); (S.-O.P.); (M.S.); (R.H.); (R.S.)
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